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My father spends up to an hour using the toilet and then arranging and rearranging his underwear and clothes. He becomes exhausted and has even fallen (no injuries, thankfully) Any ideas to help redirect him so he doesn’t risk another fall? TIA

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People with dementia often have problems doing the simplest of things, like remembering how to use the toilet and redress themselves. If your Dad is spending an hour in the bathroom, he may also be constipated, experiencing trouble urinating (an enlarged prostate is common with older men), or have a urinary infection. Consult his physician. Or he may have trouble wiping/cleaning himself; keep a supply of flushable adult wipes near the toilet. You could also install an ADA-compliant safety bar on the wall next to the toilet for safety. It will help steady him. I had to remove the lock on the bathroom door because Dad spent so much time in there and I couldn’t get to him when he fell.
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Is it possible for someone to knock on the door and tell him they needs to bathroom?

Maybe, someone telling him everything looks neat and tidy can help him feel like all is well.

I would think interrupting the behavior could prove helpful.

I can only imagine it's like a young lady back when pads were mini mattresses and you knew that everyone could see it. So adjust, check, readjust and again.

Best of luck, these behavioral challenges can be a booger to sort out.
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The OCD-like behaviors that go along with dementia are nearly impossible to stop. The best thing to do for dad would be for your mom to get him onto a toileting schedule; say, once every 3 hours or whatever, she takes him TO the bathroom and helps him. Waits for him to finish, then helps him dress/fix his clothing, and ushers him back out of the bathroom so he doesn't get caught up with fussing over his Depends & his trousers. That seems to be taking up the vast majority of the time here, so if mom starts helping him, that can cut out a lot of the problem.

As dementia advances, the behaviors have to be addressed individually and a plan devised to counteract each one. If dad is wearing trousers with a zipper and a belt, for instance, it may help tremendously to get him pull on sweat pants that eliminate the need to fuss with and adjust all the bits and bobs of the trousers. My elderly father had a terrible time with formal trousers after he fell and broke his hip, so OUT went those and IN came the sweat pants. He felt odd at first b/c they were so casual, but came to love them b/c they cut down on his frustration factor with dealing with the zippers, etc. He didn't have dementia, but other mobility and fine motor skill issues that prohibited him from fiddling around with zippers.

With dementia, they get stuck in a loop with certain things; it can take them literally 4 hours to get ready to go to an appointment, for instance, so that's when you have to plan for lots of assistance. The more that can be planned out for dad, the better. A schedule is best for folks with dementia as they can't tolerate change or deviations to the norm. Once he gets into a habit with a toileting schedule and accepting help, you should have this issue take care of fully.

Also, give him tasks to perform that he'll enjoy; like sorting nuts & bolts, folding washcloths or hand towels, shucking peas, and other repetitive-motion tasks that will keep him busy & satisfy that OCD urge that compels him.

Best of luck!
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Thanks for your response! To be more clear, we don’t want to redirect him from using the toilet, rather, redirect from the obsessive adjusting of his clothes. Dad wears Depends, the style that look most like regular briefs; but he seems to obsess over adjusting and readjusting the underwear and trousers. He has other OCD-like behaviors (folding napkins, lining up absolutely everything very precisely, etc) and the neurologist says those are all related to and part of his dementia, but the other behaviors don’t have the same physical risk of tiring himself out and falling. So we would really appreciate any ideas for redirecting or reducing the issue with adjusting his clothes during and after using the toilet. Thanks again!
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I think the answer depends on the reason - is he constipated or just obsessed with the idea of needing the toilet?
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Your profile says your mother is his primary caregiver in their home and that he has age-related decline, alzheimer's / dementia, and incontinence.

Is he using the toilet while he is wearing disposable underwear? If he still has cloth undies those should all be removed and replaced with Depends (or whatever brand).

But in terms of redirecting him to not use the toilet... retraining someone with dementia gets harder the farther along they are in the disease. How advanced is he? Has your mom tried putting a portable commode right next to his bed and spending time familiarizing him with it? Locking the bathroom door and putting a sign on it for him to use the in-room commode? Others will have more suggestions for you.
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